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OSA with Residual Sleepiness on Armodafinil AND Having Issues..

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SimplyMagick +0 points · 27 days ago Original Poster

Hi all... went searching for a forum because I don't know what to do at this point. I just moved from NY to SC and transferred from one job location to another and apparently my new region is really strict. I was spoken to the other day for laying my head on my desk for a few minutes during my lunches because passerby's thought I was sleeping while I should be working...

I have a slew of medical issues, including but not limited to, OSA with residual sleepiness (treated via CPAP and armodafinil max dosage), diabetes, depression, and anxiety. I've got a rather extensive prescription cocktail I take daily. The side effects of the meds and the illnesses make me excessively tired, and sometimes, unable to function (mostly the diabetes when I get lows). In NY, I used to be able to lay at my desk when I needed to, no questions asked, even if it was on company time (which I rarely to never did), but never had an issue. They knew my work ethic (I was with them over 2.5 years) and they were great. I transferred here a few weeks ago, laid my head on my desk 2 or 3 times last week because I wasn't feeling well, during my lunches no less, and now I feel like they are looking at me like I'm lazy. I explained to them that I have medical issues and take scripts and I'd get a dr. note if need be, but at this point I feel like it is insane that I need to defend myself this hardcore for laying my head down during my own time.

Honestly, I'm tired of living like this at all. I hear all these stories about how "CPAP changed my life!", yeah? How? Not for me... Now the armodafinil and provigil do not seem to be as effective as they once were. Now I have to find another sleep dr since I've moved and I don't even know if there is anything else I'll be able to take to help me. I'm so tired of living like this. I used to also drink about 6-8 Starbucks shots per day to help stay awake but because of financial difficulties, I've had to stop those. Anyone else have issues like these? What did you do? Any suggestions? I feel lost and resigned at this point, like I'm fighting a losing battle.

Thanks for listening... Tammy.

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Sierra +0 points · 27 days ago Sleep Innovater

Some thoughts:

  1. The armodafinil and provigil may be preventing you from getting a restful sleep. My thoughts would be to focus on getting a restful sleep, rather than to take drugs to stay awake. How is your CPAP machine working? Are you getting 7-8 hours of uninterrupted sleep each night? Are you using software like SleepyHead to monitor your detailed sleep results?
  2. I have had diabetes for nearly 20 years now, and high blood glucose can certainly make you feel tired, especially after a meal when BG tends to go up. How is your A1C? What drugs or insulin are you taking for the diabetes? Maintaining a reasonably constant BG level during the day and night is very helpful.
  3. How are your sleeping habits? I find I cannot sleep well at all if I take any caffeine after about 2:00 each day. Here is a link to a website that I have found helpful in reviewing my sleep habits and making some changes. There have a number of tools to use to evaluate sleep.

SleepWell - It's No Dream

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SimplyMagick +0 points · 26 days ago Original Poster

Prior to taking the armodafinil/provigil, I was falling asleep behind the wheel, even got into 2 car accidents. That is when the dr said I am part of the lucky 3 % who are not magically cured by the CPAP and who are diagnosed with "Residual Sleepiness" which sounds like a cop out.. but it is what it is. I do get around 8 hours of sleep each night, but rarely is it uninterrupted. I have had trouble sleeping for years, as I have depression/anxiety. No, I do not use software to monitor my sleep, I'll look at it though.

My A1C is 6.1. Currently, I am not taking any diabetes meds or insulin b/c I've been having very significant lows quite often. Since I've moved, my dr said she wouldn't help me any longer (she was a PA @ a PCP office) and I needed to find a endo. I tried to tell her that wouldn't happen for quite some time considering the move... but she refused to help me. So, I had to stop all of my meds I was on. She had me on 3 diabetes meds (Januvia, Metformin, and one more I can't remember right now....). I have a continuous blood glucose monitor though and my sugars are generally normal, around 100, unless I eat something no bueno or I don't eat at all.

Coffee does not really impact me anymore, never really did TBH. I tend to go to bed around 9:30pm-11pm and get up around 6am-6:45am, even on weekends the habits don't change much. But as I said, I have a lot of trouble remaining asleep. I tend to wake up at least once a night, sometimes twice. I fall back to sleep eventually (most of the time).

Also note, I was tested for narcolepsy, they said I didn't have that. And they retested me with my CPAP and said it was "effective" but it just wasn't helping me as it should due to the residual sleepiness. Just. My. Luck.

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Sierra +0 points · 26 days ago Sleep Innovater

Prior my diagnosis of diabetes I had issues of dozing off behind the wheel. In retrospect it was most likely due to high blood glucose. I did not get into the CPAP based on that issue, but I still have had issues with it from time to time on very long drives. The best software I know of for monitoring your sleep data from the CPAP is SleepyHead (also available as OSCAR). It is a free download, but requires a PC or Mac computer, and a SD card reader to transfer the data from your machine to your computer. SleepyHead is not being developed any further but still works fine. I use it. I will post an example of the kind of data it gives you at the bottom of this post. It can be helpful in determining the general quality of sleep and if there may be improvements in machine set up to improve sleep.

An A1C of 6.1 is probably considered just about ideal for a diabetic. It is supposed to be an average of the last 3 months. Does that reflect your current no treatment drugs situation? Does your BG spike high after a meal? That can cause sleepiness. I currently use metformin, plus rapid insulin (NovoRapid), and very slow acting insulin (Tresiba). It works well, but the rapid insulin has to be carefully matched to carb intake or you can get lows, which are not pleasant at all... Are there not walk in clinics in your new location that you could go to with copies of your old prescriptions to obtain new ones?

If you can't stay asleep at night you may be underestimating the impact of the coffee and other sources of caffeine taken later in the day. I have a brother that has serious sleep issues. He consumes coffee from morning to night, and says it doesn't affect him. Yet he is awake half the night...

Here is a SleepyHead daily report screenshot. If you have any questions, just ask...

Please be advised that these posts may contain sensitive material or unsolicited medical advice. MyApnea does not endorse the content of these posts. The information provided on this site is not intended nor recommended as a substitute for advice from a health care professional who has evaluated you.